Individual
PATRICE THIBODEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
400 N WASHINGTON ST, SUITE 116, FARMINGTON, MO 63640-1716
(573) 218-9653
(573) 803-1405
Mailing address
2909 INDEPENDENCE ST, CAPE GIRARDEAU, MO 63703-5044
(573) 803-1402
(573) 803-1405
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
2015035786
MO
Other
Enumeration date
02/06/2016
Last updated
02/06/2016
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